Liver Cancer
Cancer is the uncontrolled growth of abnormal cells anywhere in a body. These abnormal cells are termed cancer cells, malignant cells, or tumor cells. These cells can infiltrate normal body tissues. Many cancers and the abnormal cells that compose the cancer tissue are further identified by the name of the tissue that the abnormal cells originated from (for example, breast cancer, lung cancer, colon cancer, liver cancer).
Frequently, cancer cells can break away from this original mass of cells, travel through the blood and lymph systems, and lodge in other organs where they can again repeat the uncontrolled growth cycle. This process of cancer cells leaving an area and growing in another body area is termed metastatic spread or metastasis. For example, if breast cancer cells spread to a bone, it means that the individual has “metastatic breast cancer to bone”. This is not the same as “bone cancer,” which would the cancer had started in the bone.
What is liver cancer?
Liver cancer is cancer that begins in the cells of your liver. Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.
Not all cancers that affect the liver are considered liver cancer. Cancer that begins in another area of the body — such as the colon — and then spreads to the liver is called “metastatic colon cancer to liver” rather than “liver cancer”. Cancer that spreads to the liver is more common than cancer that begins in the liver cells.
Who can get liver cancer?
Liver cancer rarely occurs in healthy liver; and most often, people developing liver cancer have one or more of the conditions given below:
- Chronic infection with Hepatitis B or Hepatitis C: Chronic infection with the hepatitis B virus (HBV) or hepatitis C virus (HCV) increases your risk of liver cancer.
- Cirrhosis: This progressive and irreversible condition causes scar tissue to form in your liver and increases your chances of developing liver cancer.
- Excessive alcohol consumption: Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase your risk of liver cancer.
- Nonalcoholic fatty liver disease: An accumulation of fat in the liver increases the risk of liver cancer. This accumulation of fat may be due to obesity, diabetes mellitus, metabolic syndrome or dyslipidemia (high blood cholesterol or triglycerides).
- Diabetes: People with this blood sugar disorder have a greater risk of liver cancer than those who don’t have diabetes.
- Certain inherited liver diseases: Liver diseases that can increase the risk of liver cancer include hemochromatosis and Wilson’s disease.
- Exposure to aflatoxins: Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops such as corn and peanuts can become contaminated with aflatoxins, which can end up in foods made of these products.
How is liver cancer diagnosed?
Tests and procedures used to diagnose liver cancer include:
- Blood tests: Blood tests may reveal liver function abnormalities. Occasionally certain tumor markers like alphafetoprotein may rise indicating the presence of liver cancer.
- Imaging tests: Your doctor may recommend imaging tests, such as an ultrasound, tri-phasic computerized tomography (CT) scan and dynamic magnetic resonance imaging (MRI).
- FNAC or liver biopsy: Rarely your doctor may recommend removing a piece of liver tissue (by either FNAC or liver biopsy) for laboratory testing in order to make a definitive diagnosis of liver cancer.
How is liver cancer treated?
Treatment of liver cancer depends on the stage. In very early stages curative treatment in form of surgery or ablation of tumor can be offered. Liver transplantation is also offered in early stages. In middle or late stages only palliative treatment is possible which may include TACE (trans-arterial chemoembolization), TARE (trans-arterial radioembolization), or anti-liver cancer drugs like sorafenib.